Lucassen and colleagues are right to query whether obtaining consent from next of kin always protects patients' interests. In the example they give, it is quite proper to argue for a more practical approach that balances benefits and harms. However, this particular example leaves other questions unanswered.

Suppose that Ms Cole's aunt is alive but is demented and not competent to consent to any disclosure from her medical records or that she is untraceable. Even if there were no good reason to believe that she would not have objected to such disclosure, it is likely that Ms Cole would be prevented from accessing the information by the hospital, and it is unlikely that the draft …